What factors are contributing to the sudden 30% increase in customer support tickets related to Cedar (Enterprise Systems (Healthcare))'s insurance eligibility verification tool this month?

Introduction

The sudden 30% increase in customer support tickets related to Cedar's insurance eligibility verification tool is a critical issue that demands immediate attention. This analysis will systematically identify, validate, and address the root cause while considering both short-term fixes and long-term strategic implications.

I'll approach this problem by first clarifying key details, ruling out external factors, and then diving deep into the product, user journey, and metrics. From there, I'll generate data-driven hypotheses, conduct root cause analysis, and propose validation methods and solutions.

Step 1

Clarifying Questions (3 minutes)

• Looking at the timing, I'm thinking there might be a recent change in the system. Has there been any recent update or deployment to the insurance eligibility verification tool?

Why it matters: Recent changes often correlate with sudden metric shifts. Expected answer: Yes, there was a minor update two weeks ago. Impact on approach: If confirmed, I'd focus on change-related hypotheses.

• Considering user segments, I'm curious about the distribution of these tickets. Are they coming from a specific type of healthcare provider or insurance company?

Why it matters: Helps identify if the issue is localized or widespread. Expected answer: The increase is seen across various provider types. Impact on approach: A widespread issue would suggest a systemic problem rather than a user-specific one.

• Regarding performance metrics, has there been any change in the accuracy or speed of eligibility verifications recently?

Why it matters: Performance issues often lead to increased support tickets. Expected answer: No significant changes noted in our standard metrics. Impact on approach: If performance metrics are stable, we'd need to look deeper into user experience or hidden technical issues.

• Thinking about external factors, have there been any major policy changes or updates in the healthcare insurance landscape recently?

Why it matters: External changes can significantly impact how users interact with the tool. Expected answer: No major policy changes, but there's been increased scrutiny on accuracy. Impact on approach: This could indicate a shift in user behavior or expectations, rather than a tool malfunction.